Abstract
By 2030, more Americans than ever will suffer from a diagnosis of heart failure, resulting in a drastic increase within the socioeconomic burden of providing care. Coordinating care and supporting self-management are key strategies to delivery of evidenced based care while controlling costs and improving outcomes. Representing a complex disease process, the heart failure patient’s ability to recognize and respond to physiologic changes minimizes the characteristic episodes acute exacerbations. Advances in technology through remote monitoring stands to enhance the recognition and response to such changes, positively impacting the ability to self-manage and improve quality of life. The purpose of this pilot study is to provide a preliminary evaluation of the effectiveness of ambulatory monitoring’s ability to support self-management and improve quality of life through participation in an Advance Practice Registered Nurse coordinated chronic care disease management program. A one group quasi-experimental study was conducted within a rural, Midwestern Cardiology Clinic to determine. Study outcome measures included changes within Self-care of Heart Failure Index (SCHFI) scores and changes within the Kansas City Cardiomyopathy (KCCQ-12) questionnaire scores. Additionally, event days, defined as hospital admissions, ED visits, and clinic visits were studied for changes in trends before and after intervention. Participants remained free of event days and experienced improvement within their KCCQ-12 overall summary scores along with self-care confidence and management within the SCHFI pre and post intervention. Significant compliance with guide-line directed medical therapies was demonstrated as well. Remote therapeutic monitoring within an APRN Heart Failure Clinic demonstrated statistically significant improvements within health care quality of life and self-care among participants.|Keywords: heart failure, advance practice nurse, self-management, quality of life, remote monitoring.